Provider Demographics
NPI:1790800613
Name:FLORES, CARLOS ENRIQUE
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ENRIQUE
Last Name:FLORES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 NW LOOP 410
Mailing Address - Street 2:SUITE # N18A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-3824
Mailing Address - Country:US
Mailing Address - Phone:210-681-4720
Mailing Address - Fax:210-523-6677
Practice Address - Street 1:6301 NW LOOP 410
Practice Address - Street 2:SUITE # N18A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-3824
Practice Address - Country:US
Practice Address - Phone:210-681-4720
Practice Address - Fax:210-523-6677
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5676 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist